Medical Coding Auditor ensuring accuracy in diagnostic coding within healthcare records. Evaluating coding behavior and collaborating on quality assurance for healthcare providers.
Responsibilities
Analyze medical claims data and associated documentation to ensure accurate and complete diagnostic risk capture.
Document findings, including diagnosis changes and opportunities for documentation improvement, and recognize trends.
Evaluate coding and documentation behavior, providing recommendations for provider improvement.
Interpret and apply policy and coding standards (e.g., Coding Clinic) that impact financial and operational aspects of risk adjustment coding.
Collaborate and communicate effectively with internal and external sources to deliver QA findings.
Requirements
Bachelor's degree or four (4) years of relevant work experience (Required)
Three (3) years of experience as a RHIA, RHIT, or CPC certified coder within a healthcare provider organization or health insurance company (Required)
Current certification as a professional coder (RHIA, RHIT, or CPC) (Required)
CRC certification or willingness to obtain it within the first year of employment.
Additional certifications such as CCSP, CCS-H, CPC-P, and CPH-H are desirable.
Nursing or other clinical experience is a plus.
Benefits
Medical, vision, and dental coverage with low employee premiums.
Voluntary benefit offerings, including pet insurance for paw parents.
Life and disability insurance.
Retirement programs, including a 401K employer match and a pension plan that is vested after 3 years of service.
Wellness incentives with a wide range of mental well-being resources for you and your dependents.
Generous paid time off to reenergize.
Tuition assistance for both undergraduate and graduate degrees.
Employee recognition program to celebrate anniversaries and team accomplishments.
Senior Auditor focusing on technology audits within CIBC's US Internal Audit team. Conducting risk - focused audits and ensuring compliance with internal controls and regulatory requirements.
Vehicle Inventory Representative documenting vehicle details and conducting audits for automotive dealers. Traveling to assigned locations for inventory and maintaining accurate data entries across various dealerships.
Senior Internal Auditor role at TD SYNNEX ensuring compliance and improving operational controls. Engage with teams to enhance financial integrity and audit practices within the organization.
Utility Locate Auditor ensuring compliance with utility operations standards in the Denver area. Traveling between worksites and conducting inspections for safe and accurate utility oversight.
Advanced level position performing physical and remote audits of insured's business. Requirements include 5+ years’ experience in Premium Insurance Audits and ability to work independently.
Conducts insurance policy audits for Worker’s Compensation, Auto and General Liability at EXL. Scheduling and traveling within assigned territory to meet with insured and audit records.
Premium Insurance Field Auditor conducting insurance policy audits for Worker’s Compensation, Auto and General Liability. Requires travel and remote work from home office in Pueblo, CO.
Certified Coding Auditor responsible for data abstraction and compliance with coding guidelines at St. Joseph’s Health. Requires certification and relevant coding experience for professional services.
Operational Staff Auditor evaluating internal processes and risk management at AES Corporation. Collaborating with teams to enhance operational efficiency and compliance.
Clinical Provider Auditor II responsible for examining claims and identifying fraud risks at Elevance Health. Collaborating with internal teams and assisting in training new associates.